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Vol.52 No.3 contents | Japanese/English |
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- Case Report -
A Case of Delayed Complication with Good Syndrome After Thymectomy to Treat Type A Thymoma
Keishi Oda1,2, Tomotoshi Imanaga2, Riichiroh Maruyama3, Kaori Kato2, Kazuhiro Yatera1, Hiroshi Mukae11Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 2Departmemt of Respiratory Medicine, 3Department of Thoracic Surgery, Steel Memorial Yawata Hospital, Japan
Background. Good syndrome is a disease entity of thymoma complicated with hypogammaglobulinemia. It is therefore important to prevent and control infections. Case. A 75-year-old Japanese man was admitted to our hospital to evaluate a mediastinal enlargement on chest radiograph. His computed tomography and magnetic resonance imaging findings raised suspicions of thymoma, and a thymectomy was performed. Pathological findings revealed World Health Organization (WHO) classification type A thymoma. Four years after thymectomy, he started to complain of symptoms of productive cough and purulent sputum. In spite of several antimicrobial treatments by a family doctor, his respiratory symptoms and chest X-ray findings deteriorated. He was then introduced to our hospital. At the second visit, his chest and sinus computed tomography showed diffuse pulmonary centrilobular nodules and bilateral maxillary sinusitis, and the initial diagnosis was sinobronchial syndrome. He also showed hypogammaglobulinemia, was negative for HLA-B54 and B-lymphocytes were absent in peripheral blood, therefore, Good syndrome was finally diagnosed. Long-term administration of clarithromycin improved his clinical respiratory symptoms and chest radiological findings. Conclusion. We present a case of Good syndrome diagnosed long after thymectomy and also successfully treated with long-term macrolide treatment. Physicians and surgeons should keep in mind that Good syndrome can occur long after thymectomy, and early evaluation of humoral immunity and radiological examination of upper and lower respiratory tracts is important to diagnose this disease.
key words: Good syndrome, Thymoma, Hypogammaglobulinemia, Macrolide antibiotic
Received: March 8, 2012
Accepted: May 8, 2012
JJLC 52 (3): 305-309, 2012
